VI. Patho-physiology

A. Theoretical Based

Cerebrovascular disease is a group of brain dysfunctions related to disease of the blood vessels

supplying the brain. Hypertension is the most important

cause; it damages the blood vessel lining, endothelium, exposing the

underlying collagen where platelets aggregate to initiate a repairing process

which is not always complete and perfect. Sustained hypertension

permanently changes the architecture of the blood vessels making them

narrow, stiff, deformed, uneven and more vulnerable to fluctuations in blood

pressure.

A stroke is caused by the interruption of the blood supply to the brain, usuallybecause a blood vessel bursts or is blocked by a clot. This cuts off the supplyof oxygen and nutrients, causing damage to the brain tissue.

The most common symptom of a stroke is sudden weakness or numbness ofthe face, arm or leg, most often on one side of the body. Other symptomsinclude: confusion, difficulty speaking or understanding speech; difficultyseeing with one or both eyes; difficulty walking, dizziness, loss of balance orcoordination; severe headache with no known cause; fainting orunconsciousness.

The effects of a stroke depend on which part of the brain is injured and how severely it is affected. A

very severe stroke can cause sudden death. The 1990 Global Burden of Disease (GBD) study provided

the first global

estimate on the burden of 135 diseases, and cerebrovascular diseases

ranked as the second leading cause of death after ischemic heart disease.

During the past decade the quantity of especially routine mortality data hasincreased, and is now covering approximately one-third of theworld’s population. The increase in data availability provides the possibilityfor updating the estimated global burden of stroke.

Additionally, cerebrovascular disease is the leading cause of disability inadults and each year millions of stroke survivors has to adapt to a life withrestrictions in activities of daily living as a consequence of cerebrovasculardisease. Many surviving stroke patients will often depend on other people’scontinuous support to survive

Decreased Cardiac Output

Compensatory rennin-aldosterone, ADHCatecholamine compensatory releaseAdequate or increased blood volume

Increased SVR

Increased Preload, stroke volume, and Heart rateSystemic and pulmonary edema

Increased Myocardial oxygen requirementsDyspnea

Decreased Cardiac output, Decreased ejection fractionIncreased Blood pressure

Decreased tissue perfusion

Impaired cellular metabolism

B. Client Based

Modifiable:

Sedentary lifestyle Smoking: 30 sticks/day Alcohol intake: occasional Food and diet

Non-modifiable:

Age: 63 years old Gender: Male

↑ Triglycerides: 242.48 mg/dL

↓HDL: 29.73 mg/dL

Carotid stenosis